Does the use of an iodine-containing contrast agent to visualise the PICC tip in preterm babies cause hypothyroidism?

Chandra Prakash Rath1, Mary Thomas2, Drew Sullivan3

  • 1Department of Neonatology, King Edward Memorial Hospital, Perth, Western Australia, Australia.

Insights

Iodine-based contrast in preterm neonates did not affect thyroid function tests. However, it improved the certainty of peripherally inserted central catheter (PICC) tip positioning.

Area of Science:

  • Neonatal Medicine
  • Radiology
  • Endocrinology

Background:

  • Preterm neonates (<30 weeks) often require peripherally inserted central catheters (PICCs).
  • Assessing the safety and efficacy of procedures in this vulnerable population is crucial.
  • Iodine-based contrast agents are used in neonates, but their impact on thyroid function requires evaluation.

Purpose of the Study:

  • To compare thyroid function tests in preterm neonates exposed to iodine-based contrast with controls.
  • To ascertain the certainty of peripherally inserted central catheter (PICC) tip position after contrast administration.

Main Methods:

  • A randomized trial involving preterm neonates (<30 weeks) requiring a PICC.
  • Infants received either iodine-containing contrast or normal saline.
  • Thyroid-stimulating hormone (TSH) levels were measured on day 14 post-PICC insertion and day 28 of life.

Main Results:

  • No significant differences in TSH levels were observed between the contrast and control groups at day 14 or day 28.
  • PICC tip localization was more certain in the contrast-exposed group (85% vs. 55%).
  • Urinary iodine levels were significantly elevated in neonates who received contrast.

Conclusions:

  • Iodine-based contrast administration in preterm neonates does not suppress subsequent thyroid function.
  • The use of contrast enhances the certainty of peripherally inserted central catheter (PICC) tip visualization.
  • This suggests a potential benefit of contrast in improving procedural accuracy without compromising thyroid health.
Abstract

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